WO2012122183A1 - Cathéter à ballonnet et tige de support pour celui-ci - Google Patents

Cathéter à ballonnet et tige de support pour celui-ci Download PDF

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Publication number
WO2012122183A1
WO2012122183A1 PCT/US2012/027910 US2012027910W WO2012122183A1 WO 2012122183 A1 WO2012122183 A1 WO 2012122183A1 US 2012027910 W US2012027910 W US 2012027910W WO 2012122183 A1 WO2012122183 A1 WO 2012122183A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
support member
balloon
annular segments
beams
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2012/027910
Other languages
English (en)
Inventor
Justin Vo
Hong Doan
Hanh Doan
Ted Layman
Clay Northrop
Melyssa LEWIS
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Stryker NV Operations Ltd
Stryker Corp
Original Assignee
Stryker NV Operations Ltd
Stryker Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Stryker NV Operations Ltd, Stryker Corp filed Critical Stryker NV Operations Ltd
Priority to ES12709472T priority Critical patent/ES2807348T3/es
Priority to EP12709472.0A priority patent/EP2683433B1/fr
Publication of WO2012122183A1 publication Critical patent/WO2012122183A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
    • A61M25/0053—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids having a variable stiffness along the longitudinal axis, e.g. by varying the pitch of the coil or braid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/0054—Catheters; Hollow probes characterised by structural features with regions for increasing flexibility
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B26—HAND CUTTING TOOLS; CUTTING; SEVERING
    • B26D—CUTTING; DETAILS COMMON TO MACHINES FOR PERFORATING, PUNCHING, CUTTING-OUT, STAMPING-OUT OR SEVERING
    • B26D3/00—Cutting work characterised by the nature of the cut made; Apparatus therefor
    • B26D3/16—Cutting rods or tubes transversely
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/0059—Catheters; Hollow probes characterised by structural features having means for preventing the catheter, sheath or lumens from collapsing due to outer forces, e.g. compressing forces, or caused by twisting or kinking
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00—Metal working
    • Y10T29/49—Method of mechanical manufacture
    • Y10T29/49826—Assembling or joining
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T83/00—Cutting
    • Y10T83/02—Other than completely through work thickness
    • Y10T83/0304—Grooving

Definitions

  • the invention relates generally to medical devices and methods of manufacturing such devices; more particularly, to balloon catheters and balloon catheter support shafts.
  • intravascular medical devices have become an effective method for treating many types of vascular disease.
  • a suitable intravascular device is inserted into the vascular system of the patient and navigated through the vasculature to a desired target site.
  • a target site in the patient's vascular system may be accessed, including the coronary, cerebral, and peripheral vasculature.
  • Catheters are often utilized to place medical devices such as stents and embolic devices at a desired location within the body.
  • a medical prosthesis such as a stent for example, may be loaded onto a catheter in a configuration having a reduced diameter and then introduced into the lumen of a body vessel. Once delivered to a target location within the body, the stent may then be expanded to an enlarged configuration within the vessel to support and reinforce the vessel wall while maintaining the vessel in an open, unobstructed condition.
  • the stent may be configured to be self-expanding, expanded by an internal radial force such as a balloon, or a combination of self-expanding and balloon expandable.
  • Balloon catheters are used in a number of endovascular applications including temporarily or permanently occluding blood flow either distal or proximal of a treatment site during neurological examinations, assisting in neurovascular embolic coiling of an aneurysm or arteriovenous malformation (AVM), and dilating narrowed blood vessels caused by vasospasm.
  • AVM arteriovenous malformation
  • fast aspiration- mediated deflation of the balloon catheter quickly restores sufficient or normal blood flow to the brain in order to avoid potential neurological impairment, such as weakness, loss of sensation, speech problems, etc.
  • a tubular support member for a balloon catheter is formed by a plurality of annular segments stacked along a longitudinal axis of the catheter, and a plurality of beams connecting respective annular segments in the stack, wherein the beams meet the respective annular segments at oblique angles, wherein each beam is rotated from a longitudinally adjacent beam by a small rotational angle and wherein the beams collectively form a helix around the longitudinal axis of the catheter.
  • respective pairs of adjacent annular segments in the stack may be connected by a respective plurality of beams that collectively form a plurality of helices around the longitudinal axis of the catheter.
  • the beams may collectively form a pair of helices that rotate in same direction around the longitudinal axis of the catheter.
  • the catheter support member may further include at least one recessed annular segment configured to seat an annular radiopaque full or split marker band, wherein a respective annular segment is disposed on opposite sides of, and adjacent to, the recessed annular segment, wherein the annular segment is raised relative to the recessed annular segment.
  • a bending stiffness of the support member preferably decreases in a distal direction along the support member. In other embodiments, the bending stiffness varies along the support member.
  • the respective annular segment widths and/or the rotational angle of the beams may vary from a proximal segment of the support member to a distal segment of the support member.
  • a balloon catheter comprising the distal support member further comprises a plurality of slots formed between respective annular segments and beams, and a balloon mounted over the annular segments and having an interior region in fluid communication with at least one slot.
  • the balloon may be attached on a proximal end to a polymer jacket extending over the support member, and on a distal end to a flexible distal tip of the catheter, such that the polymer jacket and the balloon fluidly seal the plurality of slots on the support member.
  • a tubular support member for a balloon catheter includes a plurality of respective groups of narrow annular segments, each group comprising a plurality of annular segments stacked along a longitudinal axis of the catheter.
  • a respective wide annular segment is disposed between adjacent groups of narrow annular segments, and a plurality of beams connect respective annular segments of each group of narrow annual segments, the beams connecting each group of narrow annular segments having a respective same relative rotational position about the longitudinal axis of the catheter.
  • the tubular support member is configured to improve balloon catheter performance in some or all of the following areas: (1) balloon inflation and deflation time; (2) tensile strength; (3) kink resistance; (4) tracking; and (5) stability and resistance to bowing/buckling during balloon inflation/deflation.
  • Medical catheters in accordance with embodiments of the invention may be constructed by (a) feeding a first segment of the tubular member distally through the trimming device, (b) forming a first slot into the tubular member proximal of the first segment, (c) forming a first oblique angle at a first end of the first slot, (d) forming a second oblique angle, perpendicular to the first oblique angle, at a second end of the first slot, (e) rotating the tubular member 180 degrees about its longitudinal axis, (f) forming a second slot into the tubular member proximal of the first segment, (g) forming a third oblique angle at a first end of the second slot, (h) forming a fourth oblique angle, perpendicular to the third oblique angle, at a second end of the second slot, (i) feeding the next segment of the tubular member distally through the cutting device, (j) rotating the tubular member a small angle about its
  • the angle of rotation between adjacent slot pairs may be about eight degrees.
  • the tubular member may be covered with a polymer jacket and/or a balloon may be attached to the tubular member so that the balloon defines a lumen in communication with at least one slot.
  • FIG. 1 is a plan view of a balloon catheter constructed according to one embodiment of the invention and disposed in a vessel.
  • FIG. 2 is a perspective view of a balloon catheter constructed according to one embodiment of the invention, including insets showing the catheter shaft, the balloon and various balloon support shafts.
  • FIG. 3 A is a detailed perspective view of a balloon catheter according to one embodiments of the invention.
  • FIG. 3B is a detailed perspective view of various balloon support shafts according to various embodiments of the invention.
  • FIG. 4 is a perspective view of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 5 is a perspective view of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 6 is a perspective view of the balloon support shaft of FIG. 5 in a bent configuration.
  • FIG. 7 is a detailed side view of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 8 is a detailed end view of an annular segment and two beams of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 9 is a perspective view of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 10 is a perspective view of the balloon support shaft of FIG. 9 in a bent configuration.
  • FIG. 11 is a perspective view of a balloon support shaft constructed according to one embodiment of the invention.
  • FIG. 12 is a perspective view of the balloon support shaft of FIG. 11 in a bent configuration.
  • FIGS. 13A-C are detailed perspective views of balloon support shafts according to various embodiments of the invention.
  • FIG. 14 is a flow chart showing a method of manufacturing a balloon support shaft according to one embodiment of the invention.
  • FIG. 1 is a plan view of a balloon catheter 10 disposed in a blood vessel 12.
  • Balloon catheter 10 includes a balloon 14 configured to expand to seal vessels 12 within the anatomy of a patient.
  • Balloon catheter 10 may be used for intravascular procedures.
  • balloon catheter 10 may be used in conjunction with other medical devices, such as a stent or a vaso-occlusive device, to treat and/or diagnose a medical condition.
  • FIG. 2 shows a balloon catheter 10 including an elongate member 16 having a proximal portion 18 and a distal portion 20.
  • An inflation source 22 such as a lcc or 3cc syringe 22 is attached to the elongate member 16 at its proximal end using a three-way stopcock.
  • a balloon 14 is attached to the distal end of the elongate member 16.
  • the balloon 14 is also shown in an inset (2a) in sufficient detail to display the balloon support shaft 24 in the distal portion 20 of the elongate member 16.
  • a second inset (2b) shows several balloon support shafts 24 according to various embodiments of the invention.
  • FIGS. 3A-8 show various features of the balloon support shaft 24 according to one embodiment of the invention that will be discussed in greater detail below.
  • the balloon support shaft 24 has a tubular member 26 with slots 28 formed therein.
  • the tubular member 26 defines a lumen 30 that accommodates a guidewire (not shown) and provides a fluid path for inflation and deflation of the balloon 14.
  • the structure of the tubular member 26 allows fluid communication between the lumen 30 the balloon 14 through the slots 28.
  • a guidewire seal is provided at the distal end of the balloon 14 to provide a fluid seal about the guidewire.
  • the inflation source 22 is fluidly connected to the lumen 30 into which it can introduce and withdraw inflation fluid and contrast medium. From the proximal opening of the lumen 30, the introduced fluid travels around the guidewire disposed in the lumen 30, through the slots 28, and into the interior of the balloon 14 to facilitate inflation and deflation thereof.
  • FIG. 7 shows the detailed structure of a tubular member 26 according to one embodiment of the invention.
  • the tubular member 26 is generally a stack of annular segments 32.
  • Tubular member 26 includes a plurality of slots 28 formed therein.
  • Various embodiments of arrangements and configurations of slots 28 are contemplated.
  • at least some, if not all of slots 28 are disposed at the same or a similar angle with respect to the longitudinal axis of tubular member 26.
  • slots 28 can be disposed at an angle that is perpendicular, or substantially perpendicular, and/or can be characterized as being disposed in a plane that is normal to the longitudinal axis of tubular member 26.
  • slots 28 can be disposed at an angle that is not perpendicular, and/or can be characterized as being disposed in a plane that is not normal to the longitudinal axis of tubular member 26. Additionally, a group of one or more slots 28 may be disposed at different angles relative to another group of one or more slots 28.
  • the distribution and/or configuration of slots 30 can also include, to the extent applicable, any of those described in U.S. Patent No. 7,878,984.
  • Slots 28 enhance the flexibility of tubular member 26 while retaining suitable torque transmission characteristics. Slots 28 are formed such that the annular segments 32 are interconnected by one or more beams 34, i.e., the portion of tubular member 26 remaining after slots 28 are formed therein. Such an interconnected structure displays a relatively high degree of torsional stiffness, while retaining a desired level of lateral flexibility. In some embodiments, some adjacent slots 28 can be formed such that they include portions that overlap with each other about the circumference of tubular member 26. In other embodiments, some adjacent slots 28 can be disposed such that they do not necessarily overlap with each other, but are disposed in a pattern that provides the desired degree of lateral flexibility.
  • slots 28 can be arranged along the length of, or about the circumference of, tubular member 26 to achieve desired properties.
  • adjacent slots 28, or groups of slots 28 can be arranged in a symmetrical pattern, such as being disposed essentially equally on opposite sides about the circumference of tubular member 26, or can be rotated by an angle relative to each other about the axis of tubular member 26.
  • adjacent slots 28, or groups of slots 28 may be equally spaced along the length of tubular member 26, or can be arranged in an increasing or decreasing density pattern, or can be arranged in a non-symmetric or irregular pattern.
  • tubular member 26 Other characteristics, such as slot size, slot shape and/or slot angle with respect to the longitudinal axis of tubular member 26, can also be varied along the length of tubular member 26 in order to vary the flexibility or other properties. In other embodiments, moreover, it is contemplated that the portions of the tubular member may not include any such slots 28.
  • slots 28 may be formed in groups of two, three, four, five, or more slots 28, which may be located at substantially the same location along the axis of tubular member 26. Alternatively, a single slot 28 may be disposed at some or all of these locations. Within the groups of slots 28, there may be included slots 28 that are equal in size (i.e., span the same circumferential distance around tubular member 26). In some of these as well as other embodiments, at least some slots 28 in a group are unequal in size (i.e., span a different circumferential distance around tubular member 26). Longitudinally adjacent groups of slots 28 may have the same or different configurations.
  • tubular member 26 include slots 28 that are equal in size in a first group and then unequally sized in an adjacent group. It can be appreciated that in groups that have two slots 28 that are equal in size and are symmetrically disposed around the tube circumference, the centroid of the pair of beams 34 is coincident with the central axis of tubular member 26. Conversely, in groups that have two slots 28 that are unequal in size and whose beams 34 are directly opposed on the tube circumference, the centroid of the pair of beams 34 is offset from the central axis of tubular member 26.
  • tubular member 26 include only slot groups with centroids that are coincident with the central axis of the tubular member 26, only slot groups with centroids that are offset from the central axis of tubular member 26, or slot groups with centroids that are coincident with the central axis of tubular member 26 in a first group and offset from the central axis of tubular member 26 in another group.
  • the amount of offset may vary depending on the depth (or length) of slots 28 and can include essentially any suitable distance.
  • Slots 28 can be formed by methods such as micro-machining, saw-cutting (e.g., using a diamond grit embedded semiconductor dicing blade), electron discharge machining, grinding, milling, casting, molding, chemically etching or treating, or other known methods, and the like.
  • the structure of the tubular member 26 is formed by cutting and/or removing portions of the tube to form slots 28. Examples of appropriate micromachining methods and other cutting methods, and structures for tubular members including slots and medical devices including tubular members are described in U.S. Patent Publication Nos. 2003/0069522 and 2004/0181174-A2; and in U.S. Patent Nos. 6,766,720 and 6,579,246. Examples of etching processes are described in U.S. Patent No. 5,106,455.
  • the methods for manufacturing balloon catheter 10 may include forming slots 28 in tubular member 26 using any of these or other manufacturing steps.
  • slots 28 may be formed in tubular member using a laser cutting process.
  • the laser cutting process may include essentially any suitable laser and/or laser cutting apparatus.
  • the laser cutting process may utilize a fiber laser. Utilizing processes like laser cutting may be desirable for a number of reasons.
  • laser cutting processes may allow tubular member 26 to be cut into a number of different cutting patterns in a precisely controlled manner. This may include variations in the slot width (which also may be termed "kerf), annular segment width, beam height and/or width, etc.
  • changes to the cutting pattern can be made without the need to replace the cutting instrument (e.g., a blade).
  • tubular member 26 includes a plurality of annular segments 32 including annular segment 32a, annular segment 32b, and annular segment 32c.
  • segment 32a is disposed longitudinally-adjacent (i.e., right next to) segment 32b and segment 32c is disposed longitudinally-adjacent segment 32b (oppositely segment 32a).
  • the number of annular segments 32 in a given tubular member 26 may vary depending on the structure of tubular member 26. For example, as the number of slots 28 increases, the number of annular segments 32 may similarly increase. The invention is not intended to be limited to any particular number or arrangement of annular segments 32 for any given tubular member 26 or device including a tubular member 26.
  • Segments 32a/32b/32c can be understood to be generally circumferential or "round" portions of tubular member 26 that are defined between groups or sets of slots 28.
  • segment 32a is defined between a first group of slots 28a and a second group of slots 28b.
  • segment 32b is defined between group 28b and a third group of slots 28c.
  • segment 32c is defined between group 28c and a fourth group of slots 28d.
  • each group 28a/28b/28c/28d includes two slots 28.
  • any suitable number of slots 28 may be utilized for any group 28a/28b/28c/28d.
  • the invention is not intended to be limited to any number of slots 28, groups of slots 28, or number of slots 28 per group for any given tubular member 26 or device including a tubular member 26 with slots 28.
  • tubular member 26 When slots 28 are formed in tubular member 26, a portion of tubular member 26 remains at the longitudinal location where slots 28 are formed and extends between longitudinally-adjacent annular segments 32. This portion is called a "beam" 34.
  • beams 34 are illustrated in FIG. 7 including beam 34a, beam 34a', beam 34b, beam 34b', beam 34c, beam 34c', beam 34d, and beam 34d'.
  • Beams 34a/34a'/34b/34b'/34c/34c'/34d/34d' can be understood to be portions of tubular member 26 that connects or attaches longitudinally-adjacent annular segments 32.
  • each pair of longitudinally-adjacent annular segments (e.g., 32a and 32b) is attached by two beams (e.g., 34b and 34b'), which form a beam pair at the same longitudinal location along tubular member 26.
  • segment 32b is attached to segment 32c by beams 34c and 34c'.
  • each group 28a/28b/28c/28d of slots 28 defines or leaves behind two, corresponding beams at a given longitudinal location.
  • one beam (e.g., 34a, 34b, 34c, 34d) of each beam pair can be seen from the front and the other beam (e.g., 34a', 34b', 34c', 34d') of the beam pair can be seen from the back and is shaded for clarity.
  • each beam pair is formed in the tubular member 26 such that they meet the annular segments 32 at an oblique angle, as shown in FIG. 8. Further, each beam pair is formed in the tubular member 26 such that it is rotated about the longitudinal axis of the tubular member 26 from the previous beam pair. In this embodiment, each beam pair is angularly displaced or rotated by about eight degrees from the previous beam pair, resulting in a full rotation about every 45 beam pairs.
  • the beam pairs form a double helix structure along the length of the tubular member 26 because of the oblique angle between beams 34 and annular segments 32, and the angular displacement between beam pairs. These helices, which rotate in the same direction, are shown in FIGS. 2, 3, 5, and 6.
  • the beams 34 for a continuous helix When such a structure is placed in compression or tension the helical line of beam pairs act as a continuous pair of fibers that effectively prevent length change of the structure. When loaded in tension the fibers are prevented from collapsing inward and straightening by the rib support of the annular segments 32. Conversely, when loaded in compression, the fibers are prevented from buckling individually outward by the annular segments 32.
  • the double helix arrangement of beams 34 causes the tubular member 26 to bend in a segmented manner, with more bending occurring in the first region 36 where the beam pair in the helix defines an axis approximately parallel to the plane of bending. Almost no bending in the second region 38 where the beam pair axis is perpendicular to the plane of bending.
  • Increasing the pitch of the helices increases the likelihood that several bending regions 36 will exist in the tightest predicted radius of curvature of the balloon catheter 10.
  • the helix angle may be optimized to maximize both axial stiffness and isotropic properties in bending.
  • Increasing the number of beams 34 connecting each pair of annular segments 32 results in a tubular member 26 with more isotropic bending.
  • Increasing the number connecting beams 34 from two to three gives the structure a more frequently repeating symmetry along its length. For example, a two beam structure (FIGS. 2, 3, 5, and 6) is symmetric at every 180 degrees of rotation while a three beam structure (FIGS. 9 and 10) is symmetric at every 120 degrees of rotation.
  • the three beam structure will not be as soft as a two beam structure, and may be more useful in proximal regions of the balloon catheter where greater stiffness is desired.
  • Forming groups 46 of beams 34 and narrow annular segments 32 that are rotated a large increment, such as 90 degrees, from each other where the groups 46 are joined by wider annular segments 44 also results in a more isotropic tubular structure 26.
  • the wider annular segments 44 are wide enough to resist stretching.
  • Figures 11 and 12 show one example of such a structure.
  • the beams 34 in each group 46 are all aligned in this example, however they could have a spiral pattern as well.
  • the invention is not intended to be limited to any number of beams 34, groups of beams 34, or number of beams 34 per group for any given tubular member 26 or device including a tubular member 26 with beams 34.
  • the proximal region of the device is typically in less tortuous anatomy and the bending stiffness is higher to allow the device to be pushed without bowing or buckling. Accordingly, it is desirable to create a microfabricated structure with stiffness that varies along the length of the device. For instance, the stiffness can decrease and/or increase along the length of the device. The stiffness can also decrease then increase and/or increase then decrease. The stiffness of the structure can be adjusted by increasing the beam 34 and/or annular segment 32 dimensions. These are typically varied at the same time in order to create a structure that has a more uniform distribution of stress.
  • annular segment widths and rotational angles can be varied proportional to the width of the annular segment 32 to maintain a relatively constant helical pitch along the length of the device.
  • FIGS. 13A and 13B It can be seen in FIGS. 13A to 13C that as the annular segment 32 width increases the rotational angle can be increased without creating ring structures that will be loaded in bending, tension, or compression. This results in a device with higher bending stiffness and improved pushability and resistance to buckling while still retaining relatively isotropic properties in bending.
  • annular segment widths and rotational angles can be varied (i.e., increased or decreased).
  • the plurality of slots 28 allows rapid balloon inflation and deflation.
  • the slots 28 are spaced and sized to create an extremely porous structure that allows rapid inflation and deflation from the lumen 30 of the tubular member 26 into the balloon 14.
  • the ease of inflation and deflation enable the use of higher contrast medium, which enhances balloon visibility under fluoroscopy.
  • the slot configuration also provides good axial strength (in tension and compression) as well as kinking and ovalization resistance when navigating tortuous vasculature. Further, tracking of the balloon catheter 10 is improved by varying the bending stiffness of the tubular member 26 such that it is softer at its distal end. Moreover, the tubular member 26 is more resistant to bowing and buckling during balloon inflation and deflation.
  • stiffening the proximal portion of a shaft and softening the distal end it is possible to create a net gain in buckling strength while retaining a soft distal tip, particularly for longer and larger balloon sizes (critical for atraumatic tracking).
  • softening the stiffness profile of the entire shaft for shorter and smaller balloons to create maximum distal flexibility may provide better tracking.
  • Tubular member 26 and/or other components of balloon catheter 10 may be made from a metal, metal alloy, polymer (some examples of which are described below), a metal- polymer composite, ceramics, combinations thereof, and the like, or any other suitable material.
  • suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic and/or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as INCONEL® 625, UNS: N06022 such as HASTELLOY® C- 22®, UNS: N 10276 such as HASTELLOY® C276®, other HASTELLOY® alloys, and the like), nickel-copper alloys (e.g., UNS: N04400 such as MONEL® 400, NICKEL VAC® 400, NICORRO
  • Linear elastic and/or non-super-elastic nitinol may be distinguished from super elastic nitinol in that the linear elastic and/or non- super-elastic nitinol does not display a substantial "superelastic plateau” or “flag region” in its stress/strain curve like super elastic nitinol does.
  • linear elastic and/or non-super-elastic nitinol may also be termed "substantially" linear elastic and/or non-super-elastic nitinol.
  • linear elastic and/or non-super-elastic nitinol may also be distinguishable from super elastic nitinol in that linear elastic and/or non-super-elastic nitinol may accept up to about 2-5% strain while remaining substantially elastic (e.g., before plastically deforming) whereas super elastic nitinol may accept up to about 8% strain before plastically deforming. Both of these materials can be distinguished from other linear elastic materials such as stainless steel (that can also can be distinguished based on its composition), which may accept only about 0.2-0.44% strain before plastically deforming.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy is an alloy that does not show any martensite/austenite phase changes that are detectable by DSC and DMTA analysis over a large temperature range.
  • the mechanical bending properties of such material may therefore be generally inert to the effect of temperature over this very broad range of temperature.
  • the mechanical bending properties of the linear elastic and/or non-super-elastic nickel-titanium alloy at ambient or room temperature are substantially the same as the mechanical properties at body temperature, for example, in that they do not display a super-elastic plateau and/or flag region.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy maintains its linear elastic and/or non-super-elastic characteristics and/or properties.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy may be in the range of about 50 to about 60 weight percent nickel, with the remainder being essentially titanium. In some embodiments, the composition is in the range of about 54 to about 57 weight percent nickel.
  • a suitable nickel-titanium alloy is FHP-NT alloy commercially available from Furukawa Techno Material Co. of Kanagawa, Japan. Some examples of nickel titanium alloys are described in U.S. Patent Nos. 5,238,004 and 6,508,803. Other suitable materials may include ULTANIUMTM (available from Neo- Metrics) and GUM METALTM (available from Toyota).
  • a superelastic alloy for example a superelastic nitinol can be used to achieve desired properties.
  • portions or all of tubular member 26 may also be doped with, made of, or otherwise include a radiopaque material.
  • Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user of balloon catheter 10 in determining its location.
  • Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, polymer material loaded with a radiopaque filler, and the like. Additionally, other radiopaque marker bands and/or coils may also be incorporated into the design of balloon catheter 10 to achieve the same result.
  • a degree of MRI compatibility is imparted into balloon catheter 10.
  • tubular member 26, or other portions of the balloon catheter 10 may be made of a material that does not substantially distort the image and create substantial artifacts (artifacts are gaps in the image).
  • Certain ferromagnetic materials may not be suitable because they may create artifacts in an MRI image.
  • Tubular member 26, or portions thereof may also be made from a material that the MRI machine can image.
  • Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
  • cobalt-chromium-molybdenum alloys e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like
  • nickel-cobalt-chromium-molybdenum alloys e.g., UNS: R30035 such as MP35-N® and the like
  • nitinol and the like, and others.
  • the entire balloon catheter 10 can be made of the same material along its length, or in some embodiments, can include portions or sections made of different materials.
  • the material used to construct balloon catheter 10 is chosen to impart varying flexibility and stiffness characteristics to different portions of balloon catheter 10.
  • proximal section 18 and distal section 20 of balloon catheter 10 may be formed of different materials, for example materials having different moduli of elasticity, resulting in a difference in flexibility.
  • the material used to construct proximal section 18 can be relatively stiff for pushability and torqueability
  • the material used to construct distal section 20 can be relatively flexible by comparison for better lateral trackability and steerability.
  • proximal section 18 can be formed of polyimide shaft and/or doped polytetrafluoroethylene (PTFE) reinforced with 304v stainless steel wire or ribbon variable pick braiding or variable pitch cross wounding and distal section 20 can be formed with multi-durometer polymeric outer jacket such as PEBAX® over variable pick/pitch reinforced structure.
  • PTFE polytetrafluoroethylene
  • the different portions can be connected using any suitable connecting techniques and/or with a connector.
  • the different portions of balloon catheter 10 can be connected using welding (including laser welding/bonding), soldering, brazing, adhesive, thermal bonding or the like, or combinations thereof. These techniques can be utilized regardless of whether or not a connector is utilized.
  • the connector may include any structure generally suitable for connecting portions of a balloon catheter.
  • a suitable structure includes a structure such as a hypotube or a coiled wire which has an inside diameter sized appropriately to receive and connect to the ends of the proximal portion and the distal portion.
  • any suitable configuration and/or structure can be utilized for connecting various portions of the balloon catheter 10 including those connectors described in U.S. Patent Nos. 6,918,882 and 7,071,197 and/or in U.S. Patent Publication No. 2006- 0122537.
  • a polymer jacket 40 is laminated over the tubular member 26.
  • the polymer jacket 40 may be disposed over portions or all of the tubular member 26 that may define a generally smooth outer surface for balloon catheter 10. In other embodiments, however, such a jacket 40 or covering may be absent from a portion or all of balloon catheter 10, such that the tubular member 26 may form the outer surface.
  • the jacket 40 may be made from a polymer or any other suitable material.
  • suitable polymers may include low density polyethylene (LDPE), linear low density polyethylene (LLDPE), polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA,
  • the exterior surface of the balloon catheter 10 may be sandblasted, beadblasted, sodium bicarbonate-blasted, electropolished, etc.
  • a coating for example a lubricious, a hydrophilic, a protective, or other type of coating may be applied over portions or all of the jacket 40, or in embodiments without a jacket over portion of the tubular member, or other portions of device 10.
  • the jacket 40 may comprise a lubricious, hydrophilic, protective, or other type of coating. Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves device handling and device exchanges.
  • Lubricious coatings improve steerability and improve lesion crossing capability.
  • Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof.
  • Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility.
  • the jacket 40 may be formed, for example, by coating, extrusion, co-extrusion, interrupted layer co-extrusion (ILC), or fusing several segments end-to-end.
  • the layer may have a uniform stiffness or a gradual reduction in stiffness from the proximal end to the distal end thereof. The gradual reduction in stiffness may be continuous as by ILC or may be stepped as by fusing together separate extruded tubular segments.
  • the jacket 40 may be impregnated with radiopaque filler materials such as barium sulfate, bismuth, or tungsten to facilitate radiographic visualization.
  • the distal portion of the balloon 14 is attached to the distal end of the tubular member 26 and to the distal flexible tip distal of the inflation ports/irrigation channels.
  • the balloon 14 is positioned on the tubular member 26 such that the balloon 14 overlies the portion of the tubular member 26 having slots 28 formed therein.
  • the balloon 14 may be made of a highly compliant material that elastically expands upon pressurization. Because the balloon 14 elastically expands from the deflated state to the inflated state, the balloon 14 has an extremely low profile in the deflated state and may be used without folding the balloon.
  • the balloon may be formed of silicone, urethane polymer, or an extruded thermoplastic elastomers polyisoprene rubber such as a 70A, 65A, 60A, 52A, 45A, 42A, 40A, 32A, 30A, 25 A, 15 A, 12 A, and 5 A durometer hydrogenated polyisoprene rubber, which is commercially available under the trade name Chronoprene TM and Mediprene TM from AdvanSource Biomaterials, Inc. and Elasto, repectively. Hydrogenated polyisoprene provides a balloon having superior performance and manufacturing attributes.
  • hydrogenated polyisoprene may be processed with standard polyolefm processing equipment to obtain balloon tubing having a wall thickness of approximately 0.001 inches to 0.010 inches and a corresponding inside diameter of approximately 0.016 inches to 0.058 inches.
  • Such tubing produces balloons having a nominal inflated outside diameter of approximately 3.0 mm to 7.5 mm.
  • the highly compliant balloon preferably elastically expands at pressures less than 1.0 ATM.
  • the highly compliant balloon may have a pressure compliance of 2.0 mm/ ATM or more at pressures less than 2.0 ATM.
  • the highly compliant balloon may have a volumetric compliance of approximately 0.3 mm per 0.01 ml to 0.5 mm per 0.01 ml at pressures less than 2.0 ATM, for balloons having a nominal diameter of approximately 3.5 mm and a length of approximately 10 mm to 30 mm.
  • the ends of the balloon are attached to the tubular member 26 and the flexible distal tip using conventional bonding means such as thermal bonding using a hot jaw, hot air source, or a laser.
  • the tubular member 26, excluding the balloon 14 and distal flexible tip can be coated with hydrophilic coatings such as Hydropass, Hydrolene or Bioslide.
  • marker bands 42 are mounted on the tubular member 26.
  • Fig. 5 shows the recessed wide annular segment 32 configured to hold the cylindrical marker band 42 in FIG. 4.
  • the annular segments 32 on either side of the recessed wide annular segment 32 are raised relative to the recessed wide annular segments 32 (not beyond the outer diameter of the tubular member 26) to retain the marker band 42 therein.
  • the marker band 42 may be made of a full band, slit band, or coil wound of round or ribbon wire made of materials like Platinum/Tungsten, Gold.
  • the marker band 42 may also be made from a low durometer polymer or any other suitable materials impregnated with radiopaque filler materials such as Barium Sulfate, Bismuth or Tungsten to facilitate radiographic visualization.
  • suitable polymers may include low density polyethylene (LDPE), linear low density polyethylene (LLDPE), elastomeric polyamides, block polyamide/ethers, poly ether block amide (PEBA, for example available under the trade name PEBAX®).
  • LDPE low density polyethylene
  • LLDPE linear low density polyethylene
  • PEBA poly ether block amide
  • a balloon catheter 10 may be manufactured by first mounting a tubular member 26 in a trimming device (step 50). Next, a first annular segment 32 of the tubular member 26 is fed distally through the trimming device (step 52). Then, a first slot 28 is formed into the tubular member 26 proximal of the first annular segment 32, e.g. by laser cutting (step 54). Subsequently, a first oblique angle is formed at a first end of the first slot 28 (step 56).
  • a second oblique angle, perpendicular to the first oblique angle, is formed at a second end of the first slot 28 (step 58). Then, the tubular member 26 is rotated 180 degrees about its longitudinal axis (step 60). Subsequently, a second slot 28 is formed into the tubular member 26 proximal of the first annular segment 32 (step 62).
  • a third oblique angle is formed at a first end of the second slot 28 (step 64).
  • a fourth oblique angle perpendicular to the first oblique angle, is formed at a second end of the second slot 28 (step 66).
  • the next annular segment 32 of the tubular member 26 is fed distally through the cutting device (step 68).
  • tubular member is rotated a small angle (about eight degrees) about its longitudinal axis (step 70).
  • Step 54 to step 70 are repeated until a plurality of slots 28 have been cut into the tubular member 26 (step 72), at which time the tubular member 26 is removed from the trimming device (step 74).
  • the tubular member 26 is covered with a polymer jacket 40.
  • a balloon 14 is attached to the tubular member 26 so that the balloon 14 defines a lumen in communication with at least one slot 28.

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  • Health & Medical Sciences (AREA)
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Abstract

La présente invention concerne un dispositif de support de cathéter tubulaire (26) qui comprend une pluralité de segments annulaires (32) empilés le long d'un axe longitudinal du cathéter, et a une pluralité de traverses (34) raccordant des segments annulaires respectifs dans l'empilage, les traverses atteignant les segments annulaires respectifs à des angles obliques et formant collectivement une hélice autour de l'axe longitudinal du cathéter.
PCT/US2012/027910 2011-03-07 2012-03-06 Cathéter à ballonnet et tige de support pour celui-ci Ceased WO2012122183A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
ES12709472T ES2807348T3 (es) 2011-03-07 2012-03-06 Catéter balón y eje de soporte para el mismo
EP12709472.0A EP2683433B1 (fr) 2011-03-07 2012-03-06 Cathéter à ballonnet et tige de support pour celui-ci

Applications Claiming Priority (2)

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US201161449996P 2011-03-07 2011-03-07
US61/449,996 2011-03-07

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EP (1) EP2683433B1 (fr)
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US20130184644A1 (en) 2013-07-18
US20120232479A1 (en) 2012-09-13
ES2807348T3 (es) 2021-02-22
EP2683433B1 (fr) 2020-04-29
US8585643B2 (en) 2013-11-19
EP2683433A1 (fr) 2014-01-15
US9162040B2 (en) 2015-10-20

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